Evaluation of Electrocardiographic Changes and Clinical Cardiac Complications in Critically Ill COVID-19 Patients

Document Type : Original Article


1 Department of Cardiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.

2 Echocardiography Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.

3 Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.


Background: COVID-19 is associated with various cardiovascular manifestations and complications leading to even death. Electrocardiography (ECG), on the strength of its low cost and wide accessibility, is one of the leading approaches to assessing cardiac involvement and its extent. We aimed to investigate ECG abnormalities in patients with COVID-19.
Methods: The present cross-sectional descriptive study was performed on 480 patients with COVID-19 admitted to the intensive care unit, where they underwent ECG recording. Mortality and cardiovascular events were assessed during hospitalization.
Results: We evaluated 480 patients with confirmed COVID-19. Abnormal ECG findings were found among 351 patients (73.1%), with the most frequent ECG findings being sinus tachycardia (35%), ST depression (32.5%), T-wave inversion (23.8%), and ST elevation (18.8%). The most common cardiovascular event was acute coronary syndrome, reported in 216 patients (45%). Myocarditis and pericarditis were observed in 54 (11.3%) and 42 (8.8%) patients, respectively. Heart failure was reported in 138 patients (28.7). During hospitalization, 66 patients (13.8%) expired.
Conclusions: Our results showed a high prevalence of rhythm and rate abnormalities and cardiovascular events among patients without a known history of cardiac diseases. (Iranian Heart Journal 2023; 24(4): 70-75)


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